A strong skeleton becomes even more important as we age, helping us maintain an upright posture and preventing osteoporosis and fractures. Unfortunately, one in two adults over the age of 50 has low bone mass, which is a risk factor for osteoporosis.
We all know that one of the best ways to protect your bones is through nutrition, but getting plenty of calcium isn’t enough. In fact, taking calcium supplements without getting enough vitamin D may not be very effective. Read on to learn more about the roles calcium and vitamin D play in the body and how they work together to support your health.
Why we need calcium
You probably know that calcium is important for strong bones, but that’s not all it does for your body. Here are some of its main functions:
- Improves bone and tooth structure
- Promotes healthy tissue for normal movement
- Regulating vasoconstriction (for cardiovascular health)
- Helps muscles function
- Supports blood clotting
- Promotes signaling in the nervous system
- Regulation of hormone secretion
Required quantity
The Recommended Dietary Allowances (RDA) for calcium are based primarily on age, and also by gender, for adults 51 to 70 years of age. The total daily recommended amounts of calcium from foods and supplements are:
- 0-6 months: 200 milligrams
- 7 to 12 months: 260 mg
- 1 to 3 years: 700 mg
- 4-8 years: 1,000 mg
- 9-13 years: 1,300 mg
- 14-18 years: 1,300 mg
- 19-50 years: 1,000 mg
- 51-70 years old: 1,000 mg for men, 1,300 mg for women
- Age 71 and older: 1,200 mg
Why do we need Vitamin D?
Vitamin D plays many roles in normal bodily function. Spoiler alert: one of them is working with calcium to promote bone health. Here are the main reasons why you need Vitamin D:
- Calcium absorption in the intestinal tract
- Maintaining normal levels of calcium and phosphate in the blood
- Supports Bone Health
- Reduces inflammation
- Glucose metabolism
- Cellular Health
- Immune function
Required quantity
Like calcium, the RDAs for vitamin D vary by age and are based on total intake from supplements and foods. The RDAs are:
- 0-12 months: 400 international units
- 1–70 years: 600 IU
- Age 71 and older: 800 IU
Of course, exposure to sunlight is one of the best ways to get vitamin D, but there are real dangers to getting too much sun, and these dietary recommendations are designed for people who don’t get much sun exposure.
What is the relationship between Vitamin D and Calcium?
Vitamin D and calcium are inseparable when it comes to overall health and well-being. In fact, one of vitamin D’s main roles is to promote calcium absorption. “Vitamin D acts like a key that opens the door for calcium absorption in the intestine,” explains Taher Saifullah, M.D., founder of the Spine and Pain Institute in Los Angeles.
“Not having enough vitamin D can dramatically reduce calcium absorption and impair bone mineralization, which can lead to problems like osteoporosis,” says Saifullah. It can also lead to calcium deficiency, adds Soma Mandal, MD, a board-certified internist at Summit Health in New Providence, New Jersey.
So, should you take vitamin D and calcium together?
When asked whether you should take calcium and vitamin D together, experts say yes. “The combination is often recommended for preventing and treating osteoporosis and other conditions related to bone loss,” says Mandal.
Research backs up these claims. A meta-analysis of six studies found that taking vitamin D and calcium supplements together reduced the risk of any fracture by 6% and the risk of hip fracture by 16% in older adults. This combination proved to be much more effective at reducing fracture risk. Taking vitamin D alone offered no protective benefit.
Another study found that combined calcium and vitamin D supplementation significantly reduced the incidence of hip fractures, especially in postmenopausal women. “This combination is especially important for older adults, people who don’t get enough sun exposure, or people with certain health conditions,” Seifuller says.
That being said, not everyone needs to take these supplements. If you consume enough foods rich in calcium and vitamin D, such as fortified dairy products, oily fish, and eggs, and you’re not at risk for deficiencies, you probably don’t need a supplement. In fact, studies have shown that dairy products fortified with calcium and vitamin D may be more helpful in improving overall bone density in postmenopausal women than supplements. Dairy products appear to enhance the effects of these two nutrients on bones.
Potential Side Effects and Risks
Taking vitamin D and calcium is generally safe. However, there are certain risks to be aware of.
For starters, calcium supplements can cause gastrointestinal symptoms like constipation, gas, and bloating, says Mandal. Plus, taking too much calcium can increase your risk of kidney stones, especially if you’re not drinking enough water, adds Saifulla. A safe upper limit is 2,500 mg of calcium (2,000 mg if you’re over 51), an amount that’s unlikely to cause side effects.
Some studies have also found that calcium supplements may increase the risk of cardiovascular disease, but results have been mixed and the association is currently controversial. “In rare cases, taking too much of these supplements can cause hypercalcemia (high calcium levels in the blood), which can lead to symptoms like nausea, vomiting, confusion and irregular heartbeat,” Mandal says.
Additionally, these supplements may interact with certain medications, such as statins, steroids, thiazide diuretics, levothyroxine, lithium, quinolone antibiotics, and dolutegravir.,If you buy your calcium supplement at a pharmacy, you might want to stop and ask the pharmacist if there is any possibility that it might interact with any medications you currently take.
How to take Vitamin D and Calcium supplements
Dose
The recommended daily allowance for adults is 600-800 IU of vitamin D and 1,000-1,300 mg of calcium. One study found that older adults may reduce their risk of fractures if they consume 400-800 IU of vitamin D and 1,000-1,200 mg of calcium per day.
That said, supplements should fill in any missing nutrients in your diet and meet the specific needs of your nutritional deficiencies or health conditions, so if you eat plenty of calcium-rich foods and get plenty of sun exposure, you may need little or no supplements.
Consult your healthcare provider for individualized recommendations based on your diet, health condition, medication and supplement intake, and nutritional needs.
timing
“Vitamin D should be taken with meals that contain healthy fats for best absorption. Calcium is best taken in divided doses throughout the day, no more than 500-600 mg at a time,” advises Seifulle. If you’re taking a combination calcium and vitamin D supplement, check the dosage and talk to your healthcare professional to determine whether you should take it in divided doses or all at once.
Other factors to consider
If you’re not sure if you need a supplement, a health care professional can do a blood test to check your vitamin D levels. A registered dietitian can also help you evaluate your dietary intake of each nutrient to see if you’re meeting your daily needs through diet alone. Seifuller says they might also monitor your levels periodically to check on your health.
Additionally, when choosing supplements, be sure to buy from a reputable manufacturer that has been third-party tested for purity and potency, as the FDA does not verify these factors before supplements are sold.
Conclusion
There’s no question that calcium and vitamin D are both necessary for good health, especially bone health. Taking them together has been proven to be more effective than either of them alone, but there are potential side effects, especially if taken in excess. Before starting any new supplements, consult with your healthcare provider for advice on safety and appropriate dosages.
